The time is ripe to engage Iran’s incoming president

From Kate Gould, Friends Committee on National Legislation:
Rep. Ted PoeLloyd (Ted) Theodore PoeSheila Jackson Lee tops colleagues in House floor speaking days over past decade Senate Dem to reintroduce bill with new name after 'My Little Pony' confusion Texas New Members 2019 MORE’s (R-Texas) rejection of engagement with Iran’s president-elect, Hassan Rouhani, ignores major diplomatic opportunities for a reset in U.S.-Iran relations (“New president of Iran is no moderate,” July 16). It would be a grave mistake for the U.S. to miss these potential opportunities to resolve the crisis over Iran’s nuclear program and prevent a devastating war.


Poe is right to point out that the ultimate political authority in Iran rests with Iran’s Supreme Leader Ali Khamenei, not the office of the president. However, it should be obvious from former President Mahmoud Ahmadinejad’s tenure that the president of Iran also has significant influence on U.S.-Iran relations. Just as Ahmadinejad’s anti-Semitic, hard-line rhetoric and policies soured diplomatic prospects with Iran, Rouhani’s pro-engagement orientation presents a unique opening to press for a negotiated nuclear settlement.

Already, a broadly bipartisan group of members of Congress have acknowledged the potential for renewed negotiations to secure a negotiated nuclear agreement with Iran. Reps. Charlie Dent (R-Pa.) and David Price (D-N.C.) have authored a thoughtful letter calling on the Obama administration to “pursue the potential opportunity presented by Iran’s recent presidential election by reinvigorating U.S. efforts to secure a negotiated agreement.”

As their letter points out, it remains to be seen whether Rouhani can deliver on his pro-engagement platform, and abide by his pledges to work toward the release of political prisoners.

However, Dent, Price and their fellow signers rightly caution that “it would be a mistake not to test whether Dr. Rouhani’s election represents a real opportunity for progress toward a verifiable, enforceable agreement on Iran’s nuclear program that ensures the country does not acquire a nuclear weapon.”

A group of 29 former U.S. diplomats, military officials and other national security heavyweights have also joined these members of Congress in urging President Obama to take advantage of what they call “a major opportunity to reinvigorate diplomatic efforts.” Former U.S. Ambassador to the United Nations Thomas Pickering, former State Department Policy Planning Chief Anne-Marie Slaughter and the other signatories caution that “in the leadup to Rouhani’s inauguration, it is critical that all parties abstain from provocative actions that could imperil this diplomatic opportunity.”

Rejecting Rouhani’s pro-engagement stance out of hand is precisely the sort of provocation that these national security officials warn against. While Poe claims that “the supreme leader is still driving toward nuclear weapons,” the U.S. intelligence community has concluded that Iran has not yet made a decision to build nuclear weapons. Implicit threats of regime change from Poe and others will only embolden hard-liners in Iran who press for a nuclear deterrent, and undermine Rouhani’s professed position of “constructive interaction with the outside world.” Only diplomacy can secure a long-term resolution of the crisis over Iran’s nuclear program, and any opportunity for progress on that front should not be squandered.
Washington, D.C.

Specialty medicines not main driver of health costs

From John Castellani, president and CEO, PhRMA:
Steve Miller’s op-ed on The Hill’s Congress Blog, “Without action, a one-way ticket to rising drug costs,” (July 11) misconstrues the facts and paints an inaccurate picture of both the cost of specialty medicines and the biopharmaceutical industry’s position on biosimilars.

Contrary to his assertion, specialty medicines, which are often biologic medicines, are not a main driver of health costs, even for those patients most likely to use them. Among high-cost, severely ill patients, specialty medicines accounted for just 6.6 percent of their total health plan costs, with all other medical services accounting for the remaining costs. In contrast to the small number of patients who use these drugs, they provide great value to both patients and society. By improving patient health outcomes, specialty medicines often increase people’s ability to work and engage in daily activities, helping to avoid substantial future health care services and costs.

Miller also misrepresents the ability of the unique, market-based system to control costs through negotiations between health plans and manufacturers. In fact, Express Scripts touted its ability to control both traditional and specialty medicine costs through these mechanisms in its most recent annual report. Additionally, over time, with the entry of generics and the emergence of the new biosimilars pathway, spending on older treatments declines and health care resources can be redirected toward the development of new, potentially life-saving and life-improving treatments at the leading edge of better care and outcomes for patients.

PhRMA supported enactment of the Biologics Price Competition and Innovation Act of 2009, which was included in the Affordable Care Act, because it struck an appropriate balance between encouraging innovation and facilitating timely market entry of safe and effective biosimilar products. The Food and Drug Administration has issued four draft guidances on the new biosimilar approval pathway, the latest of which was on formal biosimilar meetings. PhRMA provided comments and urged the agency to continue to issue guidance documents.

As various states explore biosimilars legislation, PhRMA believes that patient safety must be of paramount concern. This means requiring that proper safeguards are in place to ensure that the scientific, medical, and regulatory assessment of the substitutability of a biosimilar are respected.
Washington, D.C.

—This post has been updated to correct an earlier version.